Madison Kimbrell, MSW QMHP
Individual provider Active NPI Mental Health Counselor · Vienna, IL
NPI 1003434291 · NPPES record last updated Jul 14, 2020
Key facts
- NPI
- 1003434291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 101 Oliver St
Vienna, IL 62995-1660 - Phone
- (618) 658-2611
- Fax
- (618) 658-2501
- NPI assigned
- Jul 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arrowleaf | Current |
Accepting new patients | |
| Arrowleaf | Mental Health | Past |
Accepting new patients |
Locations
101 Oliver St
Vienna, IL 62995
Phone (618) 658-2611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
101 Oliver St
Vienna, IL 62995-1660
Mailing address
101 Oliver St
Vienna, IL 62995-1660
Phone (618) 658-2611
Other providers in Vienna, IL
- Amy Johnson
- Kelly Johnson
- Heather Jones
- Rachel Marie Jordan
- Nikole Justice
- Kathy Ann King
- Lovella L Lassy
- Ashley Laws
- Haley Leach
- Gregory Glenn Lence
All providers in Vienna, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.